Above the Drapes
Welcome to the premiere issue of Above the Drapes, a newsletter for prospective CRNA applicants. Each edition brings you discussions about relevant topics for CRNA applicants - thought-provoking and potentially controversial.
This month, we discuss why programs utilize science GPA as a metric for CRNA program success and the NBCRNA National Certification Exam board pass rates.
LET’S STEP INSIDE →
ISSUE 02 · JULY 2026
There is a version of CRNA admissions advice that goes like this: crush your BSN, work in the ICU for a year, get your CCRN, apply to a bunch of schools, nail your interview, and that's that. Easy-peasy.
The piece that rarely gets explained clearly is why your science GPA carries the weight it does during the application process. Not just that it matters - everyone “gets it”, but why? Sometimes you look at the application requirements and science GPA isn't even listed. However, silently they are crunching the numbers.
What is the committee trying to figure out when they pull up your transcript and look at how you did in chemistry and physiology?
The answer turns out to be more specific and more data-supported than most applicants realize.
What programs are actually filtering
Admissions committees are not simply asking: Is this person a skilled ICU nurse?
They are asking something more specific: Will this person survive three years of doctoral-level science, pass boards on the first attempt, and graduate without forcing us to spend extra time and resources? Those are different questions. And science GPA turns out to be a strong lithmus for CRNA applicants.
Programs are heavily judged on attrition, first-time NCE pass rates, and accreditation standing. A weak cohort can affect rankings, reputation, and future applicant demand. Science GPA may therefore function as risk reduction. It isn’t that the program says, "we love chemistry," but "this applicant statistically looks less likely to fail didactically."
The foundational data
The strongest study on this question analyzed 1,690 nurse anesthesia students who sat for five NCE administrations between 1987 and 1989 (I know it’s a long time ago). Researchers tested 13 academic, demographic, and preadmission variables against board performance.
Science GPA alone accounted for 24% of the variance in NCE scores. The remaining six significant predictors: overall GPA, highest degree, gender, case count, age, and years of nursing experience, contributed only an additional 3% combined. [1]
The pattern is dissecting further. The two variables applicants spend the most energy on are ICU unit type (CVICU vs MICU vs Burn) and total years of critical care experience. These factors sit at the bottom of the predictive hierarchy. They tell the committee you are ready for clinical but The variable that consistently sits at the top is the one that is hardest to fix quickly: your academic science record.
Why science GPA specifically, and not just overall GPA
A competitive cumulative GPA can be built substantially on nursing coursework, discussion boards, care plan assignments, and leadership projects. That work has real value. But it does not require the same cognitive profile as earning A's in organic chemistry, biochemistry, physiology, or advanced pharmacology.
The CRNA didactic curriculum is compressed doctoral-level science: acid-base physiology, gas laws, receptor pharmacology, cardiovascular hemodynamics, pulmonary mechanics, volatile anesthetic kinetics, neurophysiology, and pathophysiology. This has to be digested over roughly 2 years, with minimum passing thresholds of 80-85% per exam depending on institution policy.
Science GPA is the closest available record of how a candidate has handled that type of material. Programs treat it as a signal for abstract reasoning under cognitive load, not just general academic effort.
How the SEE and science GPA link
The oldest direct evidence linking science GPA to NCE performance is from 1992. But over the last decade, a newer body of evidence has filled in the mechanism, and it runs through the Self-Evaluation Examination.
The SEE is a standardized board-prep exam administered by the NBCRNA to students during their anesthesia programs. Its content outline mirrors the NCE directly. The chain of evidence now looks like this:
Science GPA → Anesthesia Program GPA → SEE Score → NCE First-Time Pass
Each link is independently supported by published data.
The NBCRNA's correlation analysis found an r-value of 0.53 between SEE and first-time NCE scores across 3,061 students. When restricted to students who took the SEE immediately before their NCE attempt, the correlation rose to 0.55 - meaning about 31% of the variation in NCE scores is explained by SEE performance alone. [3]
A 2020 peer-reviewed study in the Journal of Nursing Regulation, using NBCRNA database data on 2,568 participants, confirmed SEE success as a significant predictor of first-time NCE pass. Critically, age remained independently associated with NCE outcome even after controlling for SEE performance. [4]
The NBCRNA published a dedicated research brief in 2023 drawing on 8,552 linked student records. It is their largest SEE-NCE analysis to date. [5]
The bridge: preadmission science GPA to anesthesia didactic performance
Similar to the last paragraph, the logic from pre-admission science GPA to program success cannot be understated. Science GPA does not need to perfectly predict NCE performance by itself to matter in admissions. That is not really how programs are using it.
Programs are using science GPA as an early signal for whether an applicant is likely to handle the didactic portion of anesthesia school. Once a student is enrolled, the stronger predictors of board performance become much closer to the outcome itself: anesthesia course grades, cumulative program GPA, SEE performance, and eventually NCE result.
It is:
Preadmission science GPA → Anesthesia didactic performance → SEE score → NCE first-time pass
Admissions committees do not have your future anesthesia school GPA. They do not have your future SEE score. They do not know how you will perform when the curriculum compresses physiology, pharmacology, chemistry, equipment, acid-base, hemodynamics, and pathophysiology into a high-volume doctoral program.
What they do have is your transcript.
That transcript gives them a record of how you handled science-heavy material before anesthesia school. It is imperfect, but it is one of the few preadmission signals that maps directly onto the academic work students will be expected to do once they enter the program.
This is why recent academic repair can matter so much. A weak science GPA from years ago creates doubt. Strong recent performance in graduate pathophysiology, pharmacology, chemistry, physiology, statistics, or other rigorous science coursework helps answer the real concern:
Can this applicant still learn dense technical material quickly, repeatedly, and under pressure?
That is the question science GPA is trying to answer.
That 38-point gap between the average SEE scores of students who passed versus those who eventually failed is practically meaningful. The NBCRNA's mean benchmark for graduation is around 430. Many programs require 450 before students sit comfortably before boards. Those thresholds exist because the data supports them.
What makes the SEE connection relevant to the science GPA question: the SEE tests the same material as the NCE: pharmacology, physiology, equipment, acid-base, pathophysiology. A candidate's science GPA is their pre-program track record in the same content domains the SEE will eventually test. The chain holds because the underlying subject matter is consistent throughout.
Science GPA predicts anesthesia program GPA. Program GPA predicts SEE score. SEE score predicts NCE pass rate. Each link is independently supported. The 1992 study did not need direct replication — the mechanism has been confirmed piece by piece.
How programs actually define science GPA
There is no universal definition. Programs calculate it differently, which matters when you are interpreting your own competitiveness or deciding which courses to retake.
National University is one of the most transparent about the internal data behind this criterion. Their published FAQ states directly: "High science GPA (3.6+) has been shown to be predictive of success in our program." Their recent admitted cohort averaged a 3.6 science GPA and 3.8 cumulative GPA. [6] That is a program explicitly claiming internal predictive validity and not just using a cutoff as a gatekeeping floor.
The age signal is a science GPA signal in disguise
One of the clearest data points in the modern era comes from the NBCRNA's own annual reporting. The 2025 NCE report covers 3,294 first-time candidates and a five-year trend of 14,349 total. The pass rate breakdown by age group has been stable for five consecutive years.
Age breakdown:
Under 30: 92.1%
30–35: 87.1% 36–39: 81.7%
40 or older: 73.7%
That is an 18-point spread between the youngest and oldest cohorts, confirmed across five years of data. The NBCRNA's own language in the report points to "differences in time since formal academic preparation, testing familiarity, or competing personal responsibilities" as the likely contributor. [2]
It is not that older applicants are less capable. It is that the ability to rapidly acquire and apply dense technical material under exam conditions appears to decay with distance from structured learning. Science GPA is the closest preadmission proxy for whether that capacity currently exists.
Going from one to two years of ICU experience matters significantly for admission. Going from five to ten years likely does not move the needle - and the age data suggests it may actually correlate with lower board performance. Programs appear to have figured this out.
There is research gap worth acknowledging
The strongest direct study linking preadmission science GPA to NCE performance used data from 1987–1989. The NCE has since transitioned to a computer-adaptive format. No large, peer-reviewed study has formally re-tested this relationship on the modern exam population at scale.
What exists instead is the chain described above. Each link is individually supported. But the direct endpoint of whether preadmission science GPA predicts first-time NCE pass rates on the CAT-era exam has not been rigorously published.
Programs are likely using internal data to drive their decisions. The SEE data chain, and institutional pattern-matching to justify a criterion that has strong pass rate validity.
What this means practically
For pre-anesthesia applicants: ICU experience and good overall GPA is obviously important. You need it and it matters clinically. But the data suggests science GPA carries more admissions weight than most applicants realize. Investing in recent graduate-level science coursework, demonstrating an upward academic trend, and building a strong science-specific record is not optional polish. Based on what the research actually shows, it is the core signal programs are reading.
For current SRNAs preparing for boards: the SEE data is directly actionable. A 447 average SEE for students who pass versus 410 for students who eventually fail is worth acknowledging. Programs requiring 450 before graduation are not being conservative without reason. Structured, compression-style studying with Anki, active recall, repetition, and study groups is what the data suggests improves scores. Not just hamstrung memorization.
The broader point: CRNA programs are not being arbitrary when they scrutinize chemistry grades from a decade ago. They are running a version of academic risk modeling, whether they describe it that way or not.
Above the Drapes is a monthly newsletter on the parts of the CRNA path that do not get talked about enough. Written by Greg, CRNA.
If you have applied to a CRNA program, your data makes future issues better. [Google Forms]
Sources: [1] Kremer MJ, Faut-Callahan M, Hicks FD. CRNA. 1992. PubMed PMID: 1292319. [2] NBCRNA Annual NCE and SEE Report, CY2025. [3] NBCRNA NCE and SEE Annual Report CY2020, Pearson r=0.53, N=3,061. [4] Goode VM et al. Journal of Nursing Regulation. 2020;11(2). N=2,568. [5] NBCRNA SEE Predictive Value Research Brief, 2023. N=8,552. [6] National University DNAP Program FAQ, accessed May 2026.